Background

Nephrotic syndrome is not a disease; it is the manifestation of a wide variety of underlying

disease processes.

Objectives

The aim of the present study was to investigate different clinic-laboratory and histological

patterns of nephrotic syndrome and the relationship between its clinical character and prognosis.

Methods

From January 2010 to December 2011 the authors of the present study retrospectively and

prospectively studied 139 patients with nephrotic syndrome, diagnosed on the basis of heavy

proteinuria greater than 3 g/day, hypoalbuminemia, evidence of fluid retention or edema, and

hyperlipidemia.

Results

A total of 139 patients (M : F = 79 : 60) were included in the present study; their mean age

was 33.9 ± 13.47 years (primary : secondary nephrotic syndrome = 80 : 59). Systemic lupus

erythematosus was the most common underlying cause of secondary nephrotic syndrome

[24 cases (40.7%)], followed by DM [13 cases (23.7%)]. Renal biopsy revealed 18 patients

(30.5%) with membranoproliferative glomerulonephritis, 15 (25.43%) with membranous

nephropathy, seven (11.86%) with mesangial proliferative glomerulonephritis, six (10.16%)

with amyloidosis, five (8.47%) with focal segmental glomerulosclerosis, three (5.08%) with

diffuse proliferative glomerulonephritis, one (1.69%) with focal proliferative, minimal mesangial,

sclerosing glomerulonephritides, one patient (1.69%) with crescent glomerulonephritis, and

another one (1.69%) with IgA nephropathy. A raised serum creatinine level was found in 49

(35%) patients, and 35 (74.4%) of them had normal renal function at the last follow-up. Complete

remission of proteinuria occurred in 69 (49.6%) patients, partial remission in 53 (38.1%), and

resistant proteinuria in 17 (12.2%).

Conclusion

Clinical features and biochemical values do not give many clues about the underlying

histological types of glomerulonephritis. Therefore, renal biopsy should be carried out in all

patients with adult nephrotic syndrome, as results permit us to establish a specific diagnosis,

which helps in counseling the patients about the likely prognosis of their disease and to select a specific therapeutic regimen.